1960 Covington LaneCITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121
PHONE: 4548100
BUILDING PERMIT
Te 6& uud f. $?''
62,000
Recelpt #
N_ 10897
5_S//.S
Sitenddrese 1960 COVINGTON LN Erect lt occuPancy R3
Lot 3 eIxk 3 Sec/sut. BERKSHIRE PONDS Remodal ? Zoning Rl
Parcel No.
W IN,m, RSM HOMES
? qddress 14486 UPPER GUTHRIE CT
cnv A.V. Pno„Q 435-8868
0
?u
?
f
Name SAME 452-3499
Address
Clty Phone
Neme _
Address
City
Phone
I hereby acknowledge rhat I have reod this applicotion and state that
fhe !n(ormotion is correCf and o re; to complY with all applicoble
Stote of Minnesoto Sto utes it of Eoqon Ordirwnces.
Sipnoturc of Pe'mi /
A Bullding Permit Is issued to: RSM HOM L
all work sholl be dwm in uccordance with all qpplispb State of Mir
Hepair ? Type of Const. V
Atlditlon ? No. Stories
Move ? Length 36
Demoli9h ? Depth 46
Int Impr. ? Sq. Ft.
Install ?
Aoororols Feea
Assessment _
Woter 8 $ew.
Police -
Fire
Enp.
Planner _
Council _
Bldg. Off. 8
APC
Var. Date
Permit $ 319.00
Surcharge 31.00
PlanReview 159.54
snc 525.00
Water Conn. 500.010
WaterMeter 63.00
RoadUnit 280 00
TcPI. 132_OQ
= I Parks
Copies
rotal $2, 009.50
_ on the exprcss condiHon thot
Ciy of Eoqen Ordirances.
Buildirg Official
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121
PHONE: 4548200
BUILDING PERMIT Receipt .? _
" ' ! .? ?
1 V (? c 9J
5ite Address ,N Erect U Ocwpancy K2
Lot Block seclSub. F3??•'.KS:'1?'f' ' Remodei ? Zoning
Parcel No. Repair ? Type of Const.
Addition ? Mo. Stories
W
Name Move ?
m
li
h ?
D Length
h
3 , iTnI: f' ii
Address e
s
o
I
r
t Im
? Dept
p
n
. $q, Ft.
b City Phone S• Install ?
4
Name
Approvals
Fees
p Address Assessment Permit -? -
?
u? City Phone Water & Sew. Surcharge -5
?
Police ?
Plan Review
Name Fire SAC
Address Enp. Water Conn.
? W City Phone Plonner Water Meter
Council Road Unit
I hereby acknowledgs thof I have reod this opplicotion ond sfate that Bldg. Off. Tr. PI.
the information Is correct ond agree fo comply with all upplicobla
State of Minnesota Statutes and City of Eogan Ordinonces. qpC
Parkg
' Var. date Copies
$1pnGturo of Perm
rttte
'
N Building Pertnit is issued to: Totat
on the exprtss condition thot
pll work shall be done in occordorxe with oll opplicable State of Minnesota Stotutes and City of Eo9on Ordinances.
Buildinq Offlcial
nV
0 0•
PKmit No. Permk Holdsr Data 7elophone #
Plumbing er y_ ?
H.VA.C.
Electric
Softaner
Inapection Date Insp. Other
Footlngsl h
Footln9s II
Foundatlon
Framing Qr.?
Roofiny a `??
Rouyh Plby. 6
Z?D
?
•
RougA Htg. ?Q
Insul. /y
FlrepleCe
Final Heg. a u.? =iWAL 16. _ r
Floal Pibg.
Final
Cwt/Occ. ? /,?i ? --?/ ?5 ? ? f'd •
Water D?i? location:
WNI
Sswsr
Pr. Disp.
166-
Raoeipt MECHANICAL PERMIT Perrnit No.
CITY OF EAGAN ,
FN •
Pill in numberod Waco S/C
Type w Prini /egib/y Tot. -
.
1. Date 2. Installation Cost -??•?'
3. Job Address Lot 81k.
4. Owner
RSM wm,S, IR^^.
Tract
- • . , ?
5. Contractor Phone
6. Address
7. CitY State • Zip r •
8. Building Type: Residential ? Commercial ? Institutional O
9. Work Description: New O Add 13 Alter 0 Repair ?
10. Describe *' Fuel Type ? .
11.
No,
? Equioment BTU - M. Ea.
Forced Air No. Equipment CFM
Air Handlin
:
Mfg. g
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mf9• Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
oomply with all ordinances and oodes governing this type of work.
Signed : for
' Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Reaipt .- ? PLUMBING PERMIT Panit No.
CITY OF EAGAN _
FN '
fi!l in numbered spacea S/C
Type or Piint legiblY Toi
1. Date 2. Installation Cost
3. Job Address Lot Blk. Tract
4. Owner
5. Contractor Phone
6. Address
7. City - State Zip S. Building Type: Residential ? Commercial ? Institutional ?
9. Work Description: New m Add ? Alter ? Repair ?
10. Describe
11.
No.
i Fixtures
Water Closet No. Fixtures
l
f
C
Bath tubs esspoo
/Drain
ield
Se
tic Tank
Lavatory p
f
S
1
Shower o
tner
W
l
_L
Kitchen Sink e
l
Urinal/Bidet O
?
Laundry Tray ther •
i Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agres to
comply with all ordinanoes and codes governing this type of work.
Siyned:
for
Rouyh F inal
Inspections: Dete Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 4644100
,
Receipt PLUMBING PERMIT Permit No.
CITY OF EAGAN
Fse
Fill in numbered spaces S/C
Type or Prini legib/y Tot
1. Date 2. Installation Cost
3. Job Address . Lnt ' Blk. Tract
4. Owner
5. Contractor -eE;nr^. C??! r np- Phone
6. Address N12 L' `
-;Mrs,
7. CitY t?'State. ZiP
8. Building Type: Residential 0
9. Work Description: New ?
Commercial ? Institutional O
Add O Alter ? Repair ?
10. Describe
11.
No, Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this tYpe of work.
Signed : - for
Rough F inal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
CITY OF EAGAN
Addition BERKSHIRE PONDS Lot 3 eik 3 Parcei 10 13750 030 03
owner Street 1960 Covington Lane state
Improvement Date Amount Annuai Years Payment Receipt Date
STREET SURF. 1982 239.09 23.91 10 i$ D?? 1-2 '
STREETRESTOR. 11.985 121 - 80 8.25 15 107,30 CO?/??
GRADING
SAN SEW TRUNK qq 1$2 176.04 11.7/+ 15 117.31
SEWER LATERAL •q 1982 57.24 82 1 / a 6 t / 4-'1a / /1 -$`-?S
* 427.88 28.53 O• o o ?40
WATERMAIN Uj 1$2 46.09 3.07 15
* WATER LATERAL +
WATER AREA ?
176-04
11-74
15
STORM SEW TRK 8 Q 25.67 1 335,11 CaD i4D ? 1.2-
STORM SEW LAT
CURB & GUTTER '
SIDEWALK
STREET L{GHT
WATER CONN.
u
n
BUILDING PER.
5AC
-9253-00
PARK
a•1 I T Vt,EAGAN
3830 Ptilot Knob Road WAtER SERVICE PERMR
`
i P. O. Box 21199
<<
? Eagan, MN 55121 PERMIT NO.:
Zontng:. itI • ? . . Ci1TE:
?w?? No, of Ur?trs: 1
?inf?C
Sh* AddIlss:
Pi1i1'Iblr. ?E.-:
p
°I; ?-?2l0 / ` ry Cormection Chorge;
ze: Reoda No.: ? ^coou?rt Deposlt:
Permit Fee:
'p?m P1 wWi liW Cky of yy?• SurchorQe: -- ? M?sc. ch.ges: -
? By Total: ?',? •
? o nsp. Dote Paid:
// - Zo '
' 8 S? "'p.:
CITY OF EAGAN SMO sERM PERMIT
3830 Pilot Knob Road
P. 0. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoninp: No. of Units: -
Owrwr. . , Ilddross:
Sih Add?eu: O Jf n rj t_nr. --
'` L.
N ie ssasIr wm IV Cllr of Lop• ? i
w?. nectp:
Aaoount ? Qe - f
PenMt Fee:
Surchorpe;
Misc. Cl?o?pss;
of I.?sp.: Totol:
Dob Po1A:
?
?-_ , ; -z
2/84
? A
CITY OF EAGAN
APPL ICATION FOR PER:?IIT
SEWER AND/OR WATER CONNECTION
-(PIEASE PRINT)
1) PF.OP??''_' ACDRESS:
7•Ff:aL DE,SG'.IP'TICV:
(Inti$lock/Su ;divisicn or Tat Parcei I.D. `JL:. ,-er)
? T-F cAl Oc C?GL't? LI.Jr.ru?..ri
PPFSZ27- Si :GLF. : rtS l
2'R
_ .
-
2 CCTP= (IT :'O L't 1ITJ )
. ?R-3TC:,-s-:rrVcF y L,T'i7-s}
p L':iI=S i
? CCi?ti1E?CLa1,/:2E.'?': II,/Cr 'T_C;.'
o 1"mus-LaLIi
? 7--",'STI77- IL`:A I./Gv^ v-E ,nE:T
APPLIC:-_.llj+
A
(PLEAS" P Ifii)
NA:•? :
x?
x?D?ss :
a
k
? v-
• ??f, ?ATE, ZIP: rn
PF.OVE:
pu,;.ME7, ?77?? (PLE;,?E "r'RIN1) FOR CITY USE OHLY
y
l`lC'1'1:? :
PDDRESS:
PlU!!BERS LICfYSE:
• tive '
CITY, „STA'iE, ZIP: ?
Expire
.
PHONE: x'i r "
PlUM6ER LICENSE l#p0_,?9J'"7M 4) ? f Record
,
:nitt3
4) OCC[,^?AA]'I'fc7,,Tz•;m
UAi`'IE : (P E SE PRtNi)
ADDRESS: M"L
C'TT',r_ CfraT" vTn. Q . ` -
Pf-i0`]E:
5) INDIG'?TE :•7iiICH PER•IIT IS BEING RDQLTESTE]:
CC:kNIF.CTIQN 'PO CITY SETrJER
CG`:.;'=IC,J 'It'3 CZTY WATEf2
' OMEt (PI.I'ASE DESCMBE)
IlYV.l?ill?... VaW.
FiOFD APPP,pVID PER"2IT FC?R PICi:-G'P BY ONE OF AEU'G'E
7) SI?,?TL-RE:
M! O! 01 aL4Air-.,W i? M gn =ftaft.gMW=,r srf ?a r+s =? ?r a+? a? ?s a? s s:s :s a? a? ?? rfss f?t f? tis ?s a1t s?sasa?
F O R C I T Y U S E O N L Y '
P????I.,. Y TSSU?D
FEZS : $ ?G • Sc%
$ /G •?[%
$
$
S
$ /S/G'C? ?r • •T ../r? ...? ? ? ? .s?
v .I ? v •
$ AC;:.^.u::T D'pnSIT - j•iy'__R
$ td'nC
$ ti ?.S • ? ? s:.c
$ TR..;K :JaTE .7 as:.: ssE.:m
$ Lr.TE'RAL bLivEr IT/TRL:`Ir SE_;•7EL-
s LA TERA L Br.NEr IT/TP,U::i{ WATER
$ l-? ' cf) , WATER TREAT:IENT PLANT S L'RCHARGE
$ OTHER:
$
r?./Dv .? V1?/
W ::TL-
.^; ','7' .F..?*tTm (Tl?:tClUZE -SURCHARGi)
?
WATER METYR/COPPERHORN/OL'TS2DEE REtiDEP.
WATER TAP ( ZNCLUDE CORPORATIO:I STOP )
Sr..:LR i yP
TC TL;L
CS:1'1CUN1 PA1J"'QivEi7T #
r
J
DOES UTIL,ITY COU:VECTION REQUIP.E EXCAVATION I:V PUBLIC RIG'riT OF WAY?
[-7„ YES IF YES, THEIN A "PERU:llT FOR `ROR:: WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
NO ENGI.IEERIPIG DIVISION. LIST AS A CONDI-
TZON_
SL'EJECT TO THE FOLLOLdING CONDITIOP.S:
APPRpVEp SY:
TI':LE:
r
DATE:
WPQ w sM 5ML+W IM&40 rO 10-ffif ssg w_+s NWs ? M
Jamw"a 0t 1um
ss? ? ..
.?
"J /6 Y ?z .
1985 BUILDINC PERNIT APPLICATIDN - CITY OF EAGAH '
NOTE: ALL CONTRACTORS MUST BE LICENSED IfITH THE CITY OF EAGAM
INCLUDE 2 SETS OF PLANS
3 CERTIFZCATES OF SURVEY
1 1 SET OF ENERGY CALCULATIONS
To Be Used For: Valuation: (pZ,G?'JO Date: L
Site Address: (",z .. A.1) ? OFFICE USE ONLY
Lot: 11 Block Sect/Sub rk_ ,w-?,pnArect ?X _ Oceupancy g-3
Parcel ll Remodel , Zoning ?-I
Repair Type of Const
Owner ??/?j ??„ enlarge ` U oF Stories
Move Length ?
Address Demolish _ Depth
Cv
At?ade Sq Ft
--
City/Zip Code
--------------
Contractor ?/Ldfi f F APPROYALS
Address pssessments permit City/Zip Code Water/Sewer _ Surcharge 3l. ?
Police Plan RevieW T7, s°
U 3i? ?f e• -?? ?SACn„
Phone 52S . ?
0 nBr Conn 500.'2
Pl, nner ..
Arch./Erigr Council~ oa ??
Uni? Zgo.-
Address APCg OFf
? °1? P•
Phone // Variance LR, (6. O
/ V
?
?
7S
.. .
,??? .? ...
?..?
i ? . „
2004 RES]D .,:: : .
'iVTBUI'I1Dl7?TG PF.,I2M (T' APPLICA'TIQN
383Q PiTot ? Of Eagau
-°--- _ Krzob Road, Eagan MN 55122
- ------=- ="=---TeIep7ioiie?:651-67S=5fi75---
FAX #? 651 675 5694---=
Kew Conshuctlan R uiremenLs
3 regigtered site swteys shwri?uj.sq, ry. of (oE
20%?
maximum , sq. ftof house; and alf roofed areas
2 fof oOveraqe allowed) apies ofpNrn "showing beam $ vriodo,,ysiZes. poured found desgn, etc
3 t sef of Eneigy Cafcufafions
Rimmpies of Tree Pieseiwafkn Plan if lot plafted after711193 Joisf De?ai7 Options selecfion sheet (bldqs wifh 3 or fess unifs
uvmPLETE T[y1S AREA
Rambde7A2eoairReauiremenb 2 mpOs of pYan
1 set of Energy Calcufatlons for heated addifions
1sb surveyfoPaddiHons& decks '
Add'ih"on.-am'iqte iforr-Oe sepGcsystem
EneF9Y Code Cafegory. '- Minnesofa Ruies 7670 Cate' o1.
(dsubmission type) !Resfdentlal Venh7ation CafeBory. j Worksheef
Subinitfed
. ?,
' ?Bgy Envefope ?
Calcujybons Sabmitted
A NEW
4f J'?'7 o
,
_ inn _c Ta RLIIes??Y672
. • New Eqergy Gody yyorksheet
Subml%d
fHave you previously consfructed
ee app(ies. a building in Eqgan Nvifh a similar plan? _y _ N
icensed Pfumber
4echanicaf Confiractor
ewer/Wpter Contractor
Telephone #( )RLOCT 1 9 2004
Telephone #(
Telephone # (
herebY aPPIY for a Residential Buildan
at the work will be in gPenuit and acknowledge that the iiifo
conformauoe wi? ?e ordiu ?alion i8 complefe attd acc¢tate;
ances a,nd codes of tha Cify of Eagan
aiutes; I uuderstang #is IS not a parmit, but o?Y ? apP?ca?on for a perinit, and and the Sfafe o£ MN
rmit; that the work will be in accordance wif.h tfie a p
work is not to start witt?out a
prov fplans_ ppzoved lan u? the case ofwoik which requires a review and
t's Printed Name
APP ?anPs Signature
Installed
Siding and Windows
LIMITED POWER OF ATTORNEY
CuiJNTY OF COBB
STATE OF GEOAGIA
KNOW ALL PEOPLE BY THESE PRESENTS:
THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania
("Principal"), and a licensed contractor of R1VIA Home Services, Inc., DEA Home
Depot Installed Sa?es loca±ed at 660 Mendelssohn Avenue Nerth, Gntder: Val!ey, MNT
55427, having a license number of BC- 20268257, do hereby appoint, name and
constitute Elder-Jones Building Permit Service, Ina ("Agent") as nry true and lawful
attorney-in-fact and do authorize and grant said attorney-in-fact for me and in my
name, place and stead the power to execute, acknowledge, sign and deliver (in such
form as may be required by the municipality) a permit application, or any other
instrument(s) which may be necessary and appropriate, in order to obtain the proper
permit(s) from the City of Eagan, Minnesota for the installation, maintenance and
repair of windows and siding (the "Work").
The powers conveyed to the Agent by this Limited Powe: of Attc:riey are
limited solely to the express powers delineated herein ancl appl_y solelp to the Work.
This Limited Pawer oFAftomey shall expire and automatically be revoked on the 21st
dap of May, 2404, which date is one year from the executiou hereof. Further, the
powers conveyed by this Limited Power of Attorney may be revoked by Principal at
al1y time by express revocation and shall also be revoked by the Principal's death,
disability, incapacity or incompetence.
INWs"?'NESS WFIEREOF this Limited Power oFAttorney is ?.;;ecurtcd this
21st day of May, 2003
?? .
David N. Katz 'Ki
SWORN TO AND SUBSCRIBED BEFORE ME by David N. Katz on this
21 st day of May, 2003,
t?;r39,o i
Notary P ic in for the State o eorgia
b4y Commission Expires: January 21, 2006
396816.0
Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor.
320D Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPOT
( • ! ?
55(D5S
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OP EACAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681•4675
New Conatruction Reauirements
• 3 mgistered sile surveys showing sq. fl. of lol, sa. R. of house; an0 all roofed areas
(20Yo manimum lol wverage allrnved)
• 2 copies of plan shovnng beam 8 window s¢es: poureE founA design, etc.)
• 1 set of Energy CalcWafians
• J copias of Tree Preservation Plan il lol platted after 711193
. Rim Jaist DeWil Options selection sheet (61dgs with 3 or less uni6)
DATE ?? AW • O ?.
MULTI-FAMILY BLDG _ Y >C N
SITE ADDRESS _ _I`'I (QO CtVl'f\nfl
TYPE Of WORKJ??
- - - -?
APPLICANT Renewal By Andersen, Inc.
STREET ADDRESS 1920 County Road "C" West
Roseville, MN 55113
TELEPHONE #-S1•a?oy•4f 14- CELL
_ 0 _ 1 _ 2
PROPERTY OWNER NiryN, AII'tJE\__?) TELEPHONE#IOSI4DtO
------------------------- ------------------------------ '_'------------------"_""----------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ '.k,II\NLS01':1 RCI.ES 7670 CA'CEGORI' 1 MI\VESOT:\ RC I.1:S 7672
(J submission type) . Residen6al Ven6lation Category 1 Worksheet Submitted . New Energy Code Worksheet Su6mitted
• Energy Envelope Calculations Submitted
Plumbing Contractor:
Plumbing system includes:
Mechanical Confractor:
'v[ccliariicail scs[em includcs:
Sewer/Water Conhactor.
kir Conditioning
Hcat Rccovcry Systcm
Phone #
_STATE _ ZIP
#
SLP Eee:2U-500.t,
?
?
?-
Fee: $70.00
Phone #
------------------°---..._......---------....-------...--•---------•--------°------------.._...---°-----•-----°-------
I hereby acknowledge that I have read ihis application, state that the inf mation is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordi nces.
Sfgnature of Applicant ?
OFFICE USE ONLY
_ Water SoRener _
Water Heater _
No. of Baths
RemodeVReoair Reouiremenq
• 2 copies of plan
• 7 set o( Energy Calculatrons for heated additions
• 1 sile survey for extenor addNons 8 decks
. Indicale iF trome served by septic system for additians
_ Phone #
Iavm Sprinkler
No. of R.I. Saths
VALUATION CJ ? ?D?'O?
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated i102
RESIDENTIAL
BUILDINC PERMIT APPLICATION
CITY OF EACAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Coosiruction Reouirements
• 3 registered site surveys shovnng sq. ft. of IoL sq. ft. of house; and all roofetl areaz
(20% maximum lot coverage allowed)
• 2 capies ot plan showing 6eam 8 window saes; poured found design, etc.)
• t set of Enerqy Calculations
• 3 copies of Tree Preservation Plan if lot platted after 711193
• Rim Joist Oetail Options selection shee[ (hldgs with 3 or less units)
DATE (17 - Z-b -d 2
/-f 7 L/7
??'S! 7.SJ
RemodellRepair Reauirements
. 2 copies of plan
• 1 set of Energy Calculatbns for heated additions
• 1 si[e survey for exterior additions & tlecks
. Indicate if home served by septic system for additions
5? /
VALUATION
SITEADDRESS r CffJD L?OVtn?jf"o1? L-r/ MULTI-FAMILYBLDG_Y ?N
TYPE OF WORK R`e- r017.r- FIREPLACE(S) _ 0_ 1_ 2
APPLICANi ? ???4&-4"`, -Q.{'' O r-S
STREETADDRES?S7 I TtD? CC?(AS(M v? 'for) R?V? -S CITY ?.r'] TATEL ?ZiP?
TELEPHONE # 7-Z4I4Z3Z CELL PHONE # FAX #
PROPERTYOWNER --?! !??? }y` LL'TELEPHONE#
----------------------------------------------------------------------------------------°-----
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ yIINNLSO'1'A RUI.1:S 7670 CATL•'GORY ( N17'.
(q su6mission type) • Residential Ventila[ion Cateqory t Worksheet Submitted • Energy Envelope Calcutations Submitted Plumbing Contractor. ------- _ ____ Phonc # Plumbing system includes:
Water Softener I.awn Sprinl:lcr Water Healer No. of R.I. Badis
No. of Ra[hs
Mechan(cal Contractor:
Mcctiamicalsystcm includcs:
Sewer/Water Contractor:
Phone #
Phone #
P'ee: $70.00
°-----------------------°._.._._..--°----°---....------------°--°-----------°-----------------------------°
I hereby acknowledge ihat I have read this application, state that the informatio ' correct, and ree t c
with all applicable State of Minnesota Statutes and Cify of Eag rdin ces
Signofure of Applicant
_°_----- °--------- _____------------------------------------------------ ___------- --° -------------------- °----------
OFFICE USE ON
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
_ Air Conclilioninn
_ HcaL Rccovciy Systcm
Updated 4/02
L
/FACBE caxsuLtIHa ENGINEEIlS
ENGINEEAING PLpNHERS ond LNND iURYEYOIIS
COMPANY, INC.
1000 EAST 1461A STREET, BURNSYILLE, NiHHESOTA 35337 PM 432-3000
Cer?z?'z ca? Su.r?v-e y
LOT 3
BLOCK BL
,
3, RKSN/RE PONDS,
DAKOTA couNTY, NflNrllESOTq
? COV/NGTON (.AA/E
u o R-rH 'a
?
SGALF I" = 30' N 89° 35' 34" W .
65.Oo
- 9t?.?F a -o v?_a?
ORAINA6E AND
uTlLlTY EA56MfN7 /o' r
? ?51
`
?
30' FRo,Vj BU/LD/rVG I 37,7 43a•o m1
SE'T64CK LlNE l ?3?_0' 4 ?•o
_' DENOTES ZXISTIAlCro 6LEVA7/O"
3 l '---
9?.t..o) pE,(/oTtS PROPoSED E(.Eyq TioAl I 7fRoPo?D 7Z
? . .y
?q
?
?
m o`?JE n ].1,
F{
71,IDICqTES OIRECT/OA.f OF
SuRFACE DRAINAbf ?? N m /`?•? '?,? ? m N?
I
Fiu/SHED
6ARy6E O
,CLaa,¢ -?
? oY3,2.1) Cg3?•?.? ?/I
J1
ECEVAT/o,i/ = Q3S•6 ? j???? ?9Y?Yo) ? I
Lar
- - - .-1 - e
9•ia.s? 65.00 ?4yN.o?
N 89° 35' 34" W
Iheriby caMi fy that th ia ia a true and ecrrect rnpneentation ot a tractof
land at aho9m' and deacribed hereon.. /ts grapared by me on t?fie day Ot
.Q,J?vsT 1985
, ,
X/ 0-
Use BLUE or BLACK Ink
( y L. ¢r r---------------
lr S~r I For Office Use
I I
a City of Eatn Permit I n I
Permit Fee: V ~
3830 Pilot Knob Road I I
I Date Re eived:
Eagan MN 55122
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
INFLOW & FILTRATION PERMIT APPLICATION
Plumbing / Sewer & Water
Date n / ~~~lf Site Address:
P
Tenant: Suite
RESIDENT / OWNER Name:? Phone: " * D~ a
Address ! City / Zip: IJ
-7-1
Name: License
Address: City:
CONTRACTOR
State: / Zip: /oU Phone: Oz-2d
Contact: Email:
PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope)
TYPE OF WORK Sump Pump Repair Repair
Other: Other:
DESCRIPTION Description of work:
FEES
$55.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $
*Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.cityofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call
48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and
codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans.
i
Applicant's Printed Name Ap I' ant's Signature
i
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground ,Rough-In -Final
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA150151
Date Issued:06/22/2018
Permit Category:ePermit
Site Address: 1960 Covington Lane
Lot:3 Block: 3 Addition: Berkshire Ponds
PID:10-13750-03-030
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
James K Allen
1960 Covington Lane
Eagan MN 55122
(651) 325-7403
Air Rite Heating & Ac Inc
6935 146th Street West, #3
Apple Valley MN 55124
(952) 683-1900
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA169558
Date Issued:06/01/2021
Permit Category:ePermit
Site Address: 1960 Covington Lane
Lot:3 Block: 3 Addition: Berkshire Ponds
PID:10-13750-03-030
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Includes Skylight
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site. We encourage you to retain an electronic copy of
photos until the project passes a final inspection.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
James K & Carol L Allen
1960 Covington Ln
Saint Paul MN 55122--361
Estate Claim Services Llc
6701 Penn Ave S, Suite 201B
Richfield MN 55423
(651) 309-1114
Applicant/Permitee: Signature Issued By: Signature